Baby Blues vs Postpartum Depression

Postpartum depression (PPD) can be differentiated from the baby blues by timing, duration, and/or severity.1-7

Understanding the key differences

Baby blues

The baby blues generally peaks within the first few days postdelivery and resolves without treatment within 2 weeks.3,7

Postpartum depression

Expert opinions vary as to the timing of the onset of PPD. For example, symptoms of PPD can begin:

  • During pregnancy or following childbirth up to 4 weeks (DSM-5 definition)2
  • During pregnancy or following childbirth up to 12 months (ACOG definition)8

Without treatment, symptoms may persist for months or up to a year.9

Baby blues

Estimated to affect up to 80% of women after childbirth.3,10

Postpartum depression

In the US, estimates of new mothers identified with PPD each year vary by state from 8% to 20%, with an overall average of 11.5%.11

While symptoms of the baby blues can overlap with those of PPD, they typically3,10,12:

  1. Are generally less severe
  2. Are shorter in duration
  3. Do not interfere with daily activities
  4. Do not impair maternal function
Baby blues
Symptoms include3,12:
  • Sadness
  • Frequent crying
  • Anxiety
  • Mood swings
  • Irritability
  • Insomnia
  • Anger
  • Fatigue
Postpartum depression
Symptoms include3,13:
  • Feeling sad, hopeless, empty, or overwhelmed
  • Crying more often than usual or for no apparent reason
  • Worrying or feeling overly anxious
  • Insomnia or hypersomnia
  • Physical aches and pains
  • Changes in appetite
  • Feeling moody, irritable, or restless
  • Experiencing anger or rage
  • Trouble concentrating
  • Losing interest in activities that are usually enjoyable
  • Withdrawing from friends and family
  • Trouble bonding with her baby
  • Persistently doubting her ability to care for her baby
  • Thoughts of harming herself or her baby
  • Anxiety in the form of intrusive or obsessive thoughts about the baby
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Open dialogue can make the difference

Let your patients know that PPD is not their fault. Reassure them that speaking up can get them the help they need.

  1. Frequently Asked Questions: Postpartum Depression. American College of Obstetricians and Gynecologists website. Accessed May 24, 2018.
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association Publishing; 2013.
  3. Earls MF; Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010;126(5):1032-1039.
  4. Prevalence of Self-Reported Postpartum Depressive Symptoms—17 States, 2004-2005. Centers for Disease Control and Prevention website. Accessed November 2, 2017.
  5. Robertson E, Celasun N, Stewart DE. Risk factors for postpartum depression. In: Stewart DE, Robertson E, Dennis CL, Grace SL, Wallington T. Postpartum Depression: Literature Review of Risk Factors and Interventions. Toronto, Canada: University Health Network Women’s Health Program; 2003.
  6. Depression Among Women. Centers for Disease Control and Prevention website. Accessed May 3, 2018.
  7. Postpartum Depression Facts. National Institute of Mental Health website. Accessed November 20, 2018.
  8. Screening for Perinatal Depression. ACOG Committee Opinion No. 757. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;132:e208-212.
  9. Vliegen N, Casalin S, Luyten P. The course of postpartum depression: a review of longitudinal studies. Harv Rev Psychiatry. 2014;22(1):1-22.
  10. Moses-Kolko EL, Roth EK. Antepartum and postpartum depression: healthy mom, healthy baby. J Am Med Womens Assoc. 2004;59(3):181-191.
  11. Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL. Trends in postpartum depressive symptoms—27 states, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep. 2017;66(6):153-158.
  12. As reviewed in Thurgood S, Avery DM, Williamson L. Postpartum depression (PPD). Am J Clin Med. 2009;6(2):17-22.
  13. Abramowitz JS, Meltzer-Brody S, Leserman J, et al. Obsessional thoughts and compulsive behaviors in a sample of women with postpartum mood symptoms. Arch Womens Ment Health. 2010;13(6):523-530.